Almost Exclusively Pumping

Hello,

At about a week after my baby is born, we had a 2nd visit to her pediatrician because of her jaundice. It basically got worse and she lost 17% of her birth weight. The doctor then advised me (and also the lactation consultant from the hospital) to supplement 30ml of formula (or expressed milk) after 30 minutes of breastfeeding. In addition, I was asked to pump 8 to 12 times a day after feeding.

My baby practically feeds and sleeps on my breast at the same time. And during those times, I couldn't distinguish whether she is drinking or just making me a human pacifier. So, I just followed the 30 minutes breastfeeding and 30ml formula (or expressed milk if there is available) supplement (cup feeding). I tried to pump as much as I can but I never reached 8 times. I used Spectra S9. It was a crazy feeding schedule (including the frequent trips to the hospital). My yield never went up to 20ml and I only reached 30ml once. Hence, the supply and demand was not established.

On the 5th week, when things started to clear up, when I tried to research on how to get my milk up and correct our situation, I started to pump every 2 hours with a Spectra S1. During this week, my baby was fed on bottle. She consumes first those that I have expressed then when it's finished, she would be consuming formula. My yield slightly went up to average of 40ml per pumping session. I also noticed a change in my milk production like I'm beginning to have let-downs/leaking on one breast when the other breast being pumped. I would already also be able to tell whether my breast is full or not, etc.

I encountered few issues in between such as there's a lump on my left breast that started from the time I began to pump (until now). Some clogged ducts which a lactation consultant helped me to clear.

But now, I am getting by with 2-3 hours pumping (at night or wee hours in the morning, every 4 hours) and breastfeeding my baby at night around 9pm. During the day, she drinks expressed milk and at night, formula milk.

I am on my 5th week of scheduled pumping for my 10 week old baby. However, my yield is still almost the same, average of 40ml per session and she needs almost 80 per hourly feeding. I obviously cannot keep up anymore.

My question is, is there still hope for me to be able to keep up with her feeding needs? Would my yield get any better on the 12th week? or, would it be constantly just an average of 40ml per session?

By the way, I eat oatmeal for breakfast, take fenugreek, malunggay, mother's milk tea, red dates and always drink almost 500ml to 680ml of H20 per pumping session.

Re: Almost Exclusively Pumping

However, my yield is still almost the same, average of 40ml per session

It does appear that your pump output is low. Pump output is typically a poor reflection of milk production because there are so many variables such as the pump simply not being effective enough, baby's intake, etc. So that output would be pretty normal if baby was also nursing. But if baby is almost not nursing at all and that is what you can pump, that would indicate low production.

But I am not clear what you are saying here?

and she needs almost 80 per hourly feeding.

Do you mean 80 mils per hour or per feeding? If baby is being fed about 10-12 times a day, as is normal at this age, then about 80 mils per feeding as an average sounds about right. But not per hour. Also, if baby is getting milk when she nurses, she probably would not need 2.5 ounces 10 times a day in bottles. That would be the average typical daily total a baby needs to gain normally. If baby is nursing some of the time, they need less in bottles. And the more they nurse overall, the less they need given to them in bottles.

It might be helpful to know why your milk production is low. Low production is usually caused by something. Usually that something is not frequent enough or effective enough milk removal in the early weeks. But sometimes there is a physical or hormonal issue that existed perhaps well before baby was born. Have your discussed with your LC your personal development history? Are you on any birth control? Ever have breast surgery? Did you have trouble conceiving? Also has it been figured out whether baby can transfer milk normally and if not, why not?

Generally speaking, here is what makes for best milk production: Frequent and effective milk removal. In the first three months at least, frequent milk removal for the pumping mom would be to pump at least 8 times a 24 hour day. But that number is basically a compromise- since a nursing baby is normally going to be nursing 10+ times a day, you could say that milk removal by pump should ideally be that often. BUT because pumping is more exhausting to mom than nursing, also because a mom can usually pump for longer than baby might nurse each time, 8 is the compromise number most LCs agree on recommending. But for some moms they find they do need to pump more often to maximize their potential production.

Effective: Unfortunately pumps vary tremendously in effectiveness. And even the generally most effective pumps- hospital grade- do not always work great for all moms. Personal use pumps as a rule are not the right choice for the mom who is more or less exclusively pumping while still trying to bring in a normal milk production, but they can work better for some moms. It just depends on the individual situation. Additionally, proper flange fit is vital and some moms just happen to be an in between size and struggle with getting good flange fit. Always pumps have to be in perfect working condition and checked regularly.

Some ways to maximize pump effectiveness would be to hand express as well, perhaps after pumping, and employing massage before pumping and breast compression while pumping.

My question is, is there still hope for me to be able to keep up with her feeding needs?

Yes.

Would my yield get any better on the 12th week?

Well, not all by itself. There is nothing magical about 12 weeks or any other age. Maybe I am not understanding the question.

or, would it be constantly just an average of 40ml per session?

It may be you continue to average 40 mils per session, but maybe you can have more pumping sessions, or baby nurses more or nurses better. You may find that you increase pump frequency and get less each time but more overall. My point is, it is not about per session pump output. That is just pump output. It is about overall milk production. Production and pump output are not the same thing.

As far as is it possible to increase your milk production- yes, that is always possible. It is possible at any age. But the earlier low production is addressed the better the expected outcome.

You are already using herbal galactagogues and not seeing improvement. So that would suggest that you might need to increase the dose or try a different galactagogue. I would also suggest discussing pharmaceutical galctagogues with your doctor. If you like the reputedly galactagogue foods you are eating, great. But at this point I think it unlikely food choices are going to make a substantial difference in your milk production.

It is very important to be well hydrated for normal milk production. But studies have not seen an increase in production in mom who are over-hydrating. I have no idea how much water you need to drink to be one but not the other, just giving you that info.

An excellent book on the facts about milk production concerns, how to increase milk production and real world tips for fitting in pumping etc. is Making More Milk.

Are you interested in nursing your baby more often? It is possible that your body would respond better to your baby nursing than it does for the pump.

Re: Almost Exclusively Pumping

Thank you, lli*maddieb, for reading my long post and replying.

But I am not clear what you are saying here? Do you mean 80 mils per hour or per feeding? If baby is being fed about 10-12 times a day, as is normal at this age, then about 80 mils per feeding as an average sounds about right. But not per [I]hour.

It must have been her growth spurt because it really came to a point that she was taking in 80ml per hour.

Are you on any birth control? Ever have breast surgery? Did you have trouble conceiving?

No to all.

Also has it been figured out whether baby can transfer milk normally and if not, why not?

I assume, yes. After I nurse her, I would pump and would get about less than half of what I would normally get (which means almost nothing or I can straight away transfer to a feeding cup).

Yes. Well, not all by itself. There is nothing magical about 12 weeks or any other age. Maybe I am not understanding the question. It may be you continue to average 40 mils per session, but maybe you can have more pumping sessions, or baby nurses more or nurses better.

I was actually sort of expecting that throughout these 12 weeks, my supply will gradually increase/improve until it is established. It is already a bit discouraging that no matter what I try, the pump output is still the same or sometimes even lower.

Are you interested in nursing your baby more often? It is possible that your body would respond better to your baby nursing than it does for the pump.

As much as I want to, I cannot as I will need to go back to work by next week.

Re: Almost Exclusively Pumping

It must have been her growth spurt because it really came to a point that she was taking in 80ml per hour.

Ok. Please check my math because here is what I am thinking.
80 mils is about 2.7 ounces. Right? If your baby ate 2.7 ounces every hour for an entire day, that would be over 64 ounces. This is twice as much as normal intake which is 25-35 ounces per day. There is no way a baby would need that much to eat, growth spurt or no growth spurt. What is more likely is your baby was wishing to comfort suckle and ended up taking in that much milk/formula because when a baby comforts with a bottle, they cannot help but take in whatever is in the bottle. When a baby nurses, they have more control over milk flow and can (if they choose) slow the flow down and nurse a very long time without taking in a huge amount. This is normal because nursing is effective for both for food and comfort. While a bottle might be comforting it's design is mostly about rapid and mess free meal delivery.

Are bottles being given using paced bottle feeding method and positioning? That might help. It is very easy to over feed with bottles but it is really important to not overfeed your baby in this type of situation. One, if baby is eating more milk than any mother could reasonably be expected to make, that is obviously going to be very disheartening. But more important, overfeeding will cause baby to be less and less interested in nursing and not interested in nursing with normal vigor to transfer milk normally.

No to all.

Good!

I assume, yes. After I nurse her, I would pump and would get about less than half of what I would normally get (which means almost nothing or I can straight away transfer to a feeding cup).

What would be great is if you can do some before and after nursing weight checks. While these do not tell the whole story, (because nursing session intake varies) they would at least tell you what exactly happened at that nursing session. What you pump after baby nurses may not be accurate for this. If your baby is able to transfer 2 ounces or more in 20 minutes or so of nursing, that might indicate normal milk transfer.

I was actually sort of expecting that throughout these 12 weeks, my supply will gradually increase/improve until it is established. It is already a bit discouraging that no matter what I try, the pump output is still the same or sometimes even lower.

Here is what is generally understood about human milk production. In the normal course of things, milk production starts out as only a teeny amount available shortly after baby is born. Then in the first week production rapidly increases. It continues to increase measurably but at a much slower rate until baby is about 4-6 weeks old. What is happening is that as baby's needs increase, milk production increases. By 4-6 weeks, babies need no longer increases. So they no longer need more milk each day. A 6 month old needs no more each day than a 1 month old. So, at that point, milk production stops increasing in a 'normal' breastfeeding situation.

But this does not mean milk production cannot increase after that age. It most certainly can. But if milk production was not brought to normal levels in those first several weeks, it usually becomes overall more difficult to increase production. How difficult? It depends on many factors, including why milk production is low to begin with, how low, etc. But usually overall production can be increased. BUT, this may not mean that you get more every time you pump, at least at first. Because you may find you need to pump more often for a while. If you pump more often but get the same amount each time as before, then your milk production still would have increased. In other words when working to increase milk production, while you may see per session increase, that is not the only indication production is increasing.

When I said your production will not increase "all by itself" what I meant was that if what you are doing already is not increasing your milk production appreciably, you may need to change or increase what you are doing to increase milk production.

As much as I want to, I cannot as I will need to go back to work by next week

If you work 10 hours a day, that leaves 14 hours every day when baby can nurse, and all day on weekends/days off. Working moms who are pumping at work and are nursing when at home still can primarily nurse baby. It does mean they have to nurse baby at least some overnight, but that is the norm whether mom is working or not. Babies normally nurse night and day. Increasing the amount baby nurses should act to cut down on how much you need to supplement and how much you need to pump. Also, especially if you are someone who is not responding well to pumping, you might find that nursing more helps increase your production. This does not mean you cannot increase production just with pumping. You can, but for many moms that is much harder than if baby nurses lots as well.

I am not sure I mentioned how important it is to be sure your pump is in perfect working order and fits you properly on both sides. For a mom who is mostly pumping, it is vital that her pump work correctly and be one that overall 'works" for her. Also you can try maximizing pump effectiveness/ Some ways to maximize pump effectiveness would be to hand express as well, perhaps after pumping, and employing massage before pumping and breast compression while pumping.

Re: Almost Exclusively Pumping

Please check my math because here is what I am thinking.
80 mils is about 2.7 ounces. Right? If your baby ate 2.7 ounces every hour for an entire day, that would be over 64 ounces. This is twice as much as normal intake which is 25-35 ounces per day. There is no way a baby would need that much to eat, growth spurt or no growth spurt

.

I understand what you mean. I was freaking out when that was happening. I think on the 6th or 7th hour, I asked my mom who was helping me out to stop giving her on the next hour.

What is more likely is your baby was wishing to comfort suckle and ended up taking in that much milk/formula because when a baby comforts with a bottle, they cannot help but take in whatever is in the bottle.

I know what you mean. After the c-section operation at around 6pm, she was given to me at about 9pm. She was on my breast from that time until 3am. I didn't know what to do or what was happening. I know I had colostrum already so I just thought she was really sucking. I asked my friends who are mothers and they weren't able to answer me if that was normal because for most of them, their babies didn't latch until they got home or they weren't able to bear the first breastfeeding session because when their babies first latched on them, it was painful.

When a baby nurses, they have more control over milk flow and can (if they choose) slow the flow down and nurse a very long time without taking in a huge amount. This is normal because nursing is effective for both for food and comfort.

Would you be able to let me know how would I actually know whether she is already seeking comfort during bottle-feeding? When I nurse her now, I think I roughly can tell. Before, during the first month, I am so clueless. For bottle-feeding, it's just quite difficult to tell because when she finishes the milk, she would just cry.

Are bottles being given using paced bottle feeding method and positioning? That might help.

To be honest, it's a struggle right now since not all the time, I'm the one feeding my baby. I'm a single mom who is relying also on my mom to help me out. If it's my mom who is feeding the baby, the baby is the one who sets the pace.

What would be great is if you can do some before and after nursing weight checks. While these do not tell the whole story, (because nursing session intake varies) they would at least tell you what exactly happened at that nursing session.

I have read about this before but I was always in doubt because would you really be able to see the weight gain?

Because you may find you need to pump more often for a while. If you pump more often but get the same amount each time as before, then your milk production still would have increased. In other words when working to increase milk production, while you may see per session increase, that is not the only indication production is increasing.

Understand.

When I said your production will not increase "all by itself" what I meant was that if what you are doing already is not increasing your milk production appreciably, you may need to change or increase what you are doing to increase milk production.

When to judge that I need to change / increase my session? After 2-3 days? After a week? After 2 weeks?

Increasing the amount baby nurses should act to cut down on how much you need to supplement and how much you need to pump. Also, especially if you are someone who is not responding well to pumping, you might find that nursing more helps increase your production. This does not mean you cannot increase production just with pumping. You can, but for many moms that is much harder than if baby nurses lots as well.

I think, up until this point, my confidence in breastfeeding with my baby is not established since I know my milk is not enough. During the first few days, before I was told to supplement, I remember one night, my baby was on my breast for quite some time already (as in, hours). She then cried inconsolably hard. It was just heart-wrenching that I didn't know what was happening. I couldn't accept the fact that my milk wasn't enough cause what I was told is to trust my body that it will produce enough for my baby.

During the first few weeks of the first month, my breastfeeding session with my baby was almost 24 by 7. She would be on my breast to suck and probably to seek comfort (i.e., she sleeps on my breast and when I pull her away, she would wake up again and cry). Only when I was given the instruction to breastfeed for 30 minutes and supplement for 30ml, her weight improved and my situation as well (i.e., I'm able to take a bath, etc.). When I tried to breastfeed her without timing, even after 2 hours, she wouldn't take herself away from my breast. So, when I started to have a bit of space, I began to research on how to really get my milk up and running - that's when I discovered how to do serious pumping. That's why I just started to have a scheduled pumping on week 5.

I am not sure I mentioned how important it is to be sure your pump is in perfect working order and fits you properly on both sides. For a mom who is mostly pumping, it is vital that her pump work correctly and be one that overall 'works" for her.

Yes, you mentioned. Thank you.

Also you can try maximizing pump effectiveness/ Some ways to maximize pump effectiveness would be to hand express as well, perhaps after pumping, and employing massage before pumping and breast compression while pumping.

Re: Almost Exclusively Pumping

I asked my friends who are mothers and they weren't able to answer me if that was normal because for most of them, their babies didn't latch until they got home or they weren't able to bear the first breastfeeding session because when their babies first latched on them, it was painful.

I'm afraid your friends didn't have good information for you because their experiences are atypical. Most babies will latch within an hour of birth, and most of the time latching is not unbearably painful. If it is, that's an indication of a serious problem, and help from a LC or IBCLC should be the immediate next step.

Would you be able to let me know how would I actually know whether she is already seeking comfort during bottle-feeding? When I nurse her now, I think I roughly can tell. Before, during the first month, I am so clueless. For bottle-feeding, it's just quite difficult to tell because when she finishes the milk, she would just cry.

It is definitely hard to tell when a baby has had sufficient milk/comfort when using a bottle, which is why bottlefed babies are often overfed. Check out the paced feeding videos on YouTube if you haven't already- they should give you a sense of how a bottle feeding should look, and paced feeding can slow down a baby's intake from the bottle, leading to more time for her to decide that she is done.

Would it be possible to nurse the baby after she gets a bottle? That's often a great way to transition back to more breastfeeding, and to give baby the comfort she seeks. Concluding the feeding at the breast helps the baby associate feelings of calm, comfort, and satiety with the breast, rather than with the bottle.

I have read about this before but I was always in doubt because would you really be able to see the weight gain?

Yes, using a scale to do before-and-after weights is a great way to assess intake at the breast. But you need the right scale, which you will probably need to rent. It has to be accurate to the 1/10th of an oz.

Re: Almost Exclusively Pumping

Yes, using a scale to do before-and-after weights is a great way to assess intake at the breast. But you need the right scale, which you will probably need to rent. It has to be accurate to the 1/10th of an oz.

yes, also be careful baby is naked or only is a dry diaper. If baby poops or pees and you change the diaper between the weight checks, it would throw the check off.

I agree with mommal answers above. I will try to answer a few more of your ? from last post:

When to judge that I need to change / increase my session? After 2-3 days? After a week? After 2 weeks?

My understanding is you are currently not seeing any increase in production? So I think it is time to make changes now in strategies for increasing your production. It it not going to help anything to wait. A good book you might want to check out is Making More Milk. If you do not have time to read it all, maybe have your mom find relevant info and read those sections to you, or mark them for you.

When moms do not make enough milk for their babies to gain normally, naturally that is upsetting for a mom who wants to nurse her baby. But in such situations, even if milk production never increases all the way to the point baby can exclusively nurse, it IS still possible to continue to breastfeed while supplementing as needed.

During the first few weeks of the first month, my breastfeeding session with my baby was almost 24 by 7. She would be on my breast to suck and probably to seek comfort (i.e., she sleeps on my breast and when I pull her away, she would wake up again and cry). Only when I was given the instruction to breastfeed for 30 minutes and supplement for 30ml, her weight improved and my situation as well (i.e., I'm able to take a bath, etc.). When I tried to breastfeed her without timing, even after 2 hours, she wouldn't take herself away from my breast. So, when I started to have a bit of space, I began to research on how to really get my milk up and running - that's when I discovered how to do serious pumping. That's why I just started to have a scheduled pumping on week 5.

Be careful to not let what happened in the very early weeks with baby apparently not getting enough (and we do not know why, it may not have been your production, it may have had to do with baby not being efficient at the breast) undermine your confidence now. A healthy, well gaining 10 week old is in an entirely different situation than a baby who is a couple weeks old and not getting quite enough to eat. It will not hurt your baby in any way to encourage baby to nurse lots. As long as baby gets enough overall milk at the breast + needed supplement overall to gain normally, your baby can nurse as much as baby wishes. Scheduling so you have time to pump as well as take care of your personal needs may be helpful to you, and that would be the value of scheduling. The downside is that babies do not normally nurse on a schedule and most newborns pretty much nurse most of the time. Also, the more baby nurses, assuming baby is transferring milk, the less you need to pump, and that means that more nursing should become a time saver at some point. So when thinking about nursing vs. pumping, just keep those ideas in mind.

Re: Almost Exclusively Pumping

Thank you, llli*mommal.

Most babies will latch within an hour of birth, and most of the time latching is not unbearably painful. If it is, that's an indication of a serious problem, and help from a LC or IBCLC should be the immediate next step.

That is also what I understand that it shouldn't be painful. When my baby first latched on me, it wasn't painful. What I don't understand and what I am still pondering on is that she latched from 9pm to 3am. I cannot remember whether i have tried to unlatch her but I just thought that I should let her be the one to get off my breast and not me forcing her to un-latch.

Would it be possible to nurse the baby after she gets a bottle? That's often a great way to transition back to more breastfeeding, and to give baby the comfort she seeks. Concluding the feeding at the breast helps the baby associate feelings of calm, comfort, and satiety with the breast, rather than with the bottle.

Noted. I think she really finds comfort in sucking my breast.

Yes, using a scale to do before-and-after weights is a great way to assess intake at the breast. But you need the right scale, which you will probably need to rent. It has to be accurate to the 1/10th of an oz.

Is there any term for the weighing scale so that I know what kind of scale I need to look for?

Re: Almost Exclusively Pumping

I agree with mommal answers above. I will try to answer a few more of your ? from last post: My understanding is you are currently not seeing any increase in production? So I think it is time to make changes now in strategies for increasing your production. It it not going to help anything to wait. A good book you might want to check out is Making More Milk. If you do not have time to read it all, maybe have your mom find relevant info and read those sections to you, or mark them for you.

As I'm going back to work, my pumping schedule from let's say, 9am to 6pm would reduce to 3 (from every 2 hours to 3 hours). Would it make a difference if i'd pump more earlier in the morning and/or in the evening to compensate?

Be careful to not let what happened in the very early weeks with baby apparently not getting enough (and we do not know why, it may not have been your production, it may have had to do with baby not being efficient at the breast) undermine your confidence now. A healthy, well gaining 10 week old is in an entirely different situation than a baby who is a couple weeks old and not getting quite enough to eat. It will not hurt your baby in any way to encourage baby to nurse lots. As long as baby gets enough overall milk at the breast + needed supplement overall to gain normally, your baby can nurse as much as baby wishes. Scheduling so you have time to pump as well as take care of your personal needs may be helpful to you, and that would be the value of scheduling. The downside is that babies do not normally nurse on a schedule and most newborns pretty much nurse most of the time. Also, the more baby nurses, assuming baby is transferring milk, the less you need to pump, and that means that more nursing should become a time saver at some point. So when thinking about nursing vs. pumping, just keep those ideas in mind.

May I ask whether my baby's behavior is normal? When she is really hungry, like if it's a major feed (i.e., she woke up from a long sleep), and let's say I am confident that I have milk and latched her on, she would be sucking for a very short while then she would fall asleep again. I would switch breast to wake her up or change diaper, then she would suck for a while then would fall asleep again.. most of the time, quite long from 1 to 2 hours. I am always afraid that she was not able to drink enough so the next feeding, either I bottle feed her with expressed milk or formula.

In addition, may I ask if there is a way for me to maintain my minimal supply during period? My period has not yet come but I think it will be soon. Would the calcium-magnesium supplement really help?

Thanks again.
Hand expression video= there is an introductory section then they get into the steps. These moms just gave birth, but the concept is the same. Use this info to get started and tweak as makes sense for you- http://med.stanford.edu/newborns/pro...sing-milk.html[/QUOTE]

Re: Almost Exclusively Pumping

As I'm going back to work, my pumping schedule from let's say, 9am to 6pm would reduce to 3 (from every 2 hours to 3 hours). Would it make a difference if i'd pump more earlier in the morning and/or in the evening to compensate?

Yes. In order to increase milk production, it is important to be removing milk from your breasts as many times in 24 hours as you possibly can. The exact schedule you do this does not matter, it is just important that it happens frequently overall.

May I ask whether my baby's behavior is normal? When she is really hungry, like if it's a major feed (i.e., she woke up from a long sleep), and let's say I am confident that I have milk and latched her on, she would be sucking for a very short while then she would fall asleep again. I would switch breast to wake her up or change diaper, then she would suck for a while then would fall asleep again.. most of the time, quite long from 1 to 2 hours.

Falling asleep at the breast is entirely normal. This is how most babies comfort to sleep most of the time. So it is normal and does not indicate one way or another how much milk baby "got." Truly the best way to tell how much baby is getting at the breast is to do several before and after nursing weight checks. Also remember intake is normally not a huge amount when baby nurses. 2 ounces or so could be a complete "meal" at the breast.

then she would suck for a while then would fall asleep again.. most of the time, quite long from 1 to 2 hours.

I am a little unclear here if you mean baby nurses while asleep this long, or baby falls asleep, stops nursing, and then sleeps this long. Both would be normal typically.

I am always afraid that she was not able to drink enough so the next feeding, either I bottle feed her with expressed milk or formula.

Of course it is important to be sure baby is getting enough to eat. But again this is why behavior alone is not a good indicator. You can tell whether a baby is getting enough overall most accurately by looking at properly measured weight gain. (While before and after nursing weight checks can tell you what baby gets at an individual feeding.)

The fear that a baby might not have gotten enough is common when a baby has needed supplements. It is probably the hardest thing for parents to get past when the time to reduce supplements comes. Unfortunately, this is why so many babies who only needed supplements temporarily end up being exclusively bottle fed- because parents are not given the tools and the confidence to wean baby from supplements when and if appropriate.

In addition, may I ask if there is a way for me to maintain my minimal supply during period? My period has not yet come but I think it will be soon. Would the calcium-magnesium supplement really help?

There is no reason to assume your production would go down due to having a period. It might, it might not. If you can increase the frequency that you remove milk from the breasts, you may keep your fertility returning at bay for longer and that would be the best thing you could do for your milk production for a couple reasons. I do not know anything about hard evidence about the usefulness of calcium magnesium supplements for this particular issue, but I think it is safe to say that proper dosages of vitamin and mineral supplements cannot hurt and may help.